No, Republicans don’t have a health-care plan. Yes, they do need one.

By
Ezra Klein

I think the Right is having a bit of trouble figuring out what it’s line on health-care reform is supposed to be right now. Over at her blog, my colleague Jennifer Rubin writes that it’s a myth that Republicans don’t have a health-care reform plan. Look at Paul Ryan’s Roadmap, she says, which has lots of health-care reform ideas in it. Over at Cato, libertarian health-wonk Michael Cannon argues that it’d be crazy for Republicans to propose a health-care reform plan when simply attacking the Democrats’ plan is working so well. “Their base is happy,” Cannon writes, “It wants an all-out assault on ObamaCare, and congressional Republicans are giving it to them. Republicans are even winning the ObamaCare debate among the broader public.”

I think Cannon has the better of this argument. The Republican Party has been very clear that it does not endorse the Ryan Roadmap. As Robert Costa wrote at the National Review, “as Ryan preps for a spring budget battle, [Eric] Cantor, House Speaker John Boehner, and others are not showing much eagerness to take up the roadmap’s specifics. Ryan’s project, which proposes we curb the looming debt crisis by moving toward a defined-contribution model for entitlements over the next several decades, languishes.”

There’s nothing I love more than a good health-care plan debate, so I’d be very glad to see some senior players in the Republican Party begin endorsing health-care plans. But as of yet, they’re not doing it. The closest they’ve come is H.R. 9, which directs a couple of House committees to develop health-care ideas by some unspecified date in the future. I’d say H.R.9’s existence actually manages to undercut both Rubin and Cannon’s arguments: It simultaneously shows that Republicans haven’t settled on a health-care plan but think they’ll have to soon. And they’re right about that. By 2012, the party is going to have to be able to agree on something, because their presidential nominee is going to have to have a plan of his or her own.

"By 2012, the party is going to have to be able to agree on something, because their presidential nominee is going to have to have a plan of his or her own."

Or not -- particularly if Romney is the nominee.

If the Obama campaign thinks it's too taboo to talk about and Romney thinks it's too taboo to talk about, both sides would develop safe talking points and stick to them every time health care comes up, and neither will go after the other for fear of making it a topic.

If it plays out that way, I think that's good for Obama. He wins the issue, and it's off the board.

******But as of yet, they’re not doing it. The closest they’ve come is H.R. 9, which directs a couple of House committees to develop health-care ideas by some unspecified date in the future******

Of course they have no plan, and the reason is even the most well thought-out, most market-friendly health care reforms require AN ENLARGED ROLE FOR GOVERNMENT. There's simply no way around this fact, unless one is prepared reduce access for vulnerable groups (which is what Ryancare does).

Simply put, the GOP's lurch to the right has rendered it ideologically incapable of a meaningful contribution to healthcare reform.

I think you might have missed the bigger point about Ryan's plan, which is that Ryan does nothing to address what PPACA addressed: the prohibition on pre-existing conditions, guaranteed issue, etc. Nor does it do anything to address health care at all for anyone who is under 65. All Ryan's plan does is purportedly solve government's fiscal crisis by slashing Medicare funding. Which is fine if that's the only goal. But it misses your original point, which is Ryan does nothing for those of us under 65, while Republicans are pretending they have plans. That Jennifer Rubin would think she scores a big point by referring to Ryan shows that she doesn't get it -- the Republicans don't have a plan. Moreover, the other ideas that get thrown out there -- tort reform, HSAs, etc -- would do almost nothing about costs whatever their other merits (tort reform would save only a few billion a year at best, and HSAs and high deductible plans do nothing to address where the real costs are -- catastrophic care -- because HSAs and high deductibles essentially are just catastrophic health care plans). Selling insurance across state lines (as Republicans want that to be done) would never pass once it's explained for what it really does -- reduce costs through massive deregulation.

Republicans really do have no plan. But there is a reason for that -- at the end of the day, all they want is tax cuts and deregulation, and then they're happy.

The Republicans have hated government since Reagan said government was bad and gave us lots of bad government. You can see their priorities. Take money from government workers and give it to multi-national corporations. Bash women and their reproductive systems. Use Congress to insult Muslims including our "birther" President. You need to get in the gutter to understand Republicans.

The republican plan is to not have a plan. They do not believe in government solving any problems. The market will do that according to them. The plan is to get elected and re-elected, to give tax breaks for the wealthy (that provide them the funds for re-election), and do nothing in congress except for holding hearings. Its worked well for them, and when ever democrats try to govern, they will say Govt takeover! The only republican plan now is to get rid of Medicare, Medicaid and Social Security (and unions that do not fund their election).

What about Heritage Foundation's "The Case Against Obamacare" which "[i]dentifies key principles for a better way to reform health care" (http://www.heritage.org/research/projects/the-case-against-obamacare)?

What about the Heritage Foundation's "The Case Against Obamacare"? It's a long critique of PPACA, with a very short list of bullet points stating things they might do differently, which even in aggregate don't form anything resembling a comprehensive plan, and which thus far hasn't been taken up by Republicans or "the Right" in general.

So I think that illustrates in a few way's Ezra's point, that there still isn't an alternate plan at this point, beyond "repeal and ... ?"

The Republicans promised that they'll repeal and replace but they seem to stop at repeal. Our health care system has problems that need to be addressed. We need to make improvements so we can't keep things as they are right now. Meanwhile supporters of the law are making things happen for a lot of American families.

I'm a big fan of Ryan. But I am not convinced at all that his brethren in the GOP are serious about deficit reduction. Ryan stated in mid-February on the Greta van Susteren show that the GOP understood that you can't be serious about deficit reduction unless you are serious about entitlement reform. I'm not holding my breath on that one. I actually think a defined contribution plan is a great idea to control costs because it restores something of a price system to health care. But the GOP has neither the courage nor the smarts to back Ryan's ideas.

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